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General NPI Number Information
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NPI Number | 1336891159
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Entity Type | Individual
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Provider Name | HOLLIE PORTWINE
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Gender | Female
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Dates
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Enumeration Date | 01/23/2022
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1400 W SEMINARY ST
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-2036
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Country | US
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Telephone | 608-647-8931
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Fax |
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Provider Business Mailing Address
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Address Line | 26357 COUNTY HWY Y
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-8721
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Country | US
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Telephone | 608-632-1641
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 5747-27
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License Number State | WI
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